Changes in Retinal Nonperfusion Associated with Suppression of Vascular Endothelial Growth Factor in Retinal Vein Occlusion

Tahreem A Mir; Saleema Kherani; Gulnar Hafiz; Adrienne W Scott; Ingrid Zimmer-Galler; Adam S Wenick; Sharon Solomon; Ian Han; David Poon; Lingmin He; Syed Mahmood Shah; Christopher J Brady; Catherine Meyerle; Akrit Sodhi; Marguerite O Linz; Raafay Sophie; Peter A Campochiaro

doi:10.1016/j.ophtha.2015.10.030

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Changes in Retinal Nonperfusion Associated with Suppression of Vascular Endothelial Growth Factor in Retinal Vein Occlusion

Journal article

Open access

Peer reviewed

Changes in Retinal Nonperfusion Associated with Suppression of Vascular Endothelial Growth Factor in Retinal Vein Occlusion

Tahreem A Mir, Saleema Kherani, Gulnar Hafiz, Adrienne W Scott, Ingrid Zimmer-Galler, Adam S Wenick, Sharon Solomon, Ian Han, David Poon, Lingmin He, …

Ophthalmology (Rochester, Minn.), Vol.123(3), pp.625-634.e1

03/2016

DOI: 10.1016/j.ophtha.2015.10.030

PMCID: PMC5482175

PMID: 26712560

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https://www.ncbi.nlm.nih.gov/pmc/articles/5482175View

Open Access

Abstract

To assess changes in retinal nonperfusion (RNP) in patients with retinal vein occlusion (RVO) treated with ranibizumab. Secondary outcome measure in randomized double-masked controlled clinical trial. Thirty-nine patients with central RVO (CRVO) and 42 with branch RVO (BRVO). Subjects were randomized to 0.5 or 2.0 mg ranibizumab every month for 6 months and then were re-randomized to pro re nata (PRN) groups receiving either ranibizumab plus scatter laser photocoagulation or ranibizumab alone for an additional 30 months. Comparison of percentage of patients with increased or decreased area of RNP in patients with RVO treated with 0.5 versus 2.0 mg ranibizumab, during monthly injections versus ranibizumab PRN, and in patients treated with ranibizumab PRN versus ranibizumab PRN plus laser. In RVO patients given monthly injections of 0.5 or 2.0 mg ranibizumab for 6 months, there was no significant difference in the percentage who showed reduction or increase in the area of RNP. However, regardless of dose, during the 6-month period of monthly injections, a higher percentage of patients showed a reduction in area of RNP and a lower percentage showed an increase in area of RNP compared with subsequent periods of ranibizumab PRN treatment. After the 6-month period of monthly injections, BRVO patients, but not CRVO patients, randomized to ranibizumab PRN plus laser showed significantly less progression of RNP compared with patients treated with ranibizumab PRN. Regardless of dose (0.5 or 2.0 mg), monthly ranibizumab injections promote improvement and reduce progression of RNP compared with PRN injections. The addition of scatter photocoagulation to ranibizumab PRN may reduce progression of RNP in patients with BRVO, but a statistically significant reduction was not seen in patients with CRVO.

Retinal Vein Occlusion - physiopathology

Double-Blind Method

Follow-Up Studies

Intravitreal Injections

Tomography, Optical Coherence

Humans

Middle Aged

Male

Combined Modality Therapy

Laser Coagulation

Ranibizumab - therapeutic use

Vascular Endothelial Growth Factor A - antagonists & inhibitors

Retinal Vein - physiology

Disease Progression

Regional Blood Flow - drug effects

Retinal Vein Occlusion - drug therapy

Angiogenesis Inhibitors - therapeutic use

Female

Aged

Regional Blood Flow - physiology

Visual Acuity - physiology

Fluorescein Angiography

Details

Title: Subtitle: Changes in Retinal Nonperfusion Associated with Suppression of Vascular Endothelial Growth Factor in Retinal Vein Occlusion
Creators: Tahreem A Mir - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Saleema Kherani - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Gulnar Hafiz - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Adrienne W Scott - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Ingrid Zimmer-Galler - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Adam S Wenick - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Sharon Solomon - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Ian Han - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
David Poon - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Lingmin He - Johns Hopkins University School of Medicine
Syed Mahmood Shah - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Christopher J Brady - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Catherine Meyerle - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Akrit Sodhi - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Marguerite O Linz - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Raafay Sophie - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
Peter A Campochiaro - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: pcampo@jhmi.edu
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.123(3), pp.625-634.e1
DOI: 10.1016/j.ophtha.2015.10.030
PMID: 26712560
PMCID: PMC5482175
NLM abbreviation: Ophthalmology
ISSN: 0161-6420
eISSN: 1549-4713
Publisher: United States
Grant note: P30 EY001765 / NEI NIH HHS EY01765 / NEI NIH HHS KL2 TR001077 / NCATS NIH HHS
Language: English
Date published: 03/2016
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980077002771

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